New Study Identifies Genetic Links between Asthma, Respiratory Inhalers and Air Pollution


Denver - A pioneering study published today in Nature Communications has uncovered new insights into corticosteroids (commonly used in inhalers), asthma and air pollution. Led by National Jewish Health, the research seeks to bridge crucial gaps in understanding how environmental factors, asthma symptoms and treatment effects are interconnected.

Asthma is known to be highly hereditary, with about 50% of the risk attributed to genetics. However, many of the specific genes responsible for severe asthma symptoms, varied treatment responses and vulnerability during pollution exposure remain unknown. The recent study focused on the genomic regions that respond to corticosteroids to uncover new links between asthma, environmental triggers and therapeutic interventions. The team identified a surprising link between corticosteroid signaling, air pollution and genetic risk. The findings highlight the need for determining the long-term effectiveness and risks of using inhaled corticosteroids while exposed to air pollution.

"During periods of poor air quality, which are increasing in frequency, more people are relying on inhalers to manage respiratory symptoms," said National Jewish Health pulmonologist Anthony Gerber, MD, PhD, and lead investigator for the study. "However, we don’t yet fully understand the long-term risks of corticosteroid use, or how using inhaled corticosteroids to treat symptoms associated with air pollution may be impacting those who haven’t been properly diagnosed with asthma."

"Asthma is often diagnosed based on symptoms and sometimes treated indiscriminately with inhalers," Dr. Gerber explained. "But this approach overlooks an essential step: verifying whether asthma is truly present.”  High prescription rates for inhalers, without conclusive diagnostic testing, suggest that asthma medications may be over prescribed. Dr. Gerber noted that almost every tissue is vulnerable to side effects from exposure to corticosteroids, but this risk is not always considered when exposing the lung to inhaled medications.

Another area explored in the study involves identifying genetic links between the cellular targets of corticosteroids and asthma. These genetic links have the potential to uncover new pathways for asthma therapy and define why some patients with asthma are resistant to standard inhalers.

The study also highlights the shifting landscape of environmental factors, particularly air pollution. Over the last 25 years, air quality has steadily improved, but rising levels of particulate matter, driven in part by wildfires, have worsened air quality in many areas, particularly in Western states, since the mid-2010s. The increased prevalence of pollution-related asthma flares has spurred urgent questions about how best to address this challenge.

"Decades of poor wildland management is driving more pollution, especially in the Western United States,” Dr. Gerber said. "As a result, understanding how environmental factors like air pollution contribute to asthma has never been more critical."

Moving forward, the study’s research team plans to investigate the possibility of an “asthma pollution endotype,” where specific genetic markers might explain how exposure to pollution influences asthma development and progression. The team also plans to explore other areas of the genome that could reveal links between pollution and asthma or other lung diseases.

"We hope to pinpoint these genetic connections and to better understand how air pollution might contribute to asthma — and whether we can identify specific genetic risk factors that could guide personalized treatment strategies," said Dr. Gerber.

 

National Jewish Health is the leading respiratory hospital in the nation. Founded in 1899 as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of children and adults with respiratory, cardiac, immune, and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit the media resources page.


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